Our long term goal is to evaluate the therapeutic choice made by various urologists in their treatment of bladder carcinoma and to eventually evolve a rationale therapeutic approach to an individual tumor in a patient. At present we are conducting a double-blind study using different dosages of thio-tepa for prophylactic purposes as well as in the treatment of superficial tumors. We are also testing and evaluating on a randomized basis, pre-operative radiotherapy and surgery versus radiotherapy alone in treating some invasive tumors. To date we have entered about 108 patients in our tumor protocol. Eight patients have completed the radiotherapy part of the protocol and have experienced no problems as yet. For the present year we hope to increase the number of patients and physicians participating in the program, and to more closely follow those patients already in the program. We also expect to more objectively analyze our rationale for treatment and follow up of bladder cancer patients. Furthermore, we will attempt to identify various immunologic parameters and biochemical changes found in these patients. With this information we can then better evaluate the host tumor relationship and treat patients with therapy at an earlier stage.